Registration of Vital Events by the Civil Registry Office in an Indigenous Context: Implications for the Registration of Maternal Deaths

Abstract

This work investigates the evolution of maternal mortality in the Tztozil-Tzeltal region at Los Altos de Chiapas in Mexico. We analyzed the archive of the Civil Registry Office from the past 25 years, focusing on the registration of female deaths from obstetric diseases. This region is characterized by being composed of greater than 90% indigenous people, and the limited presence of government actions before the eruption of the Zapatista movement in 1994. A thorough study was conducted to identify the causes and risk factors for maternal mortality underreporting based upon archival research, interviews, and personal observations in the registry offices. From a historical perspective, a gradual evolution of the Civil Registry Office eliminar becoming an administrative office accountable for the national statistics on mortality is discussed. Despite the leadership of the Mexican Secretariat of Health in the standardization and systematization of demographic information, the status of state health services in this region has resulted in other local functionaries, including Justices of the Peace, municipal presidents and agents, and other authorities, to have an increasing role in the registration of such vital events such as maternal death reporting in this region.